Gestión de la calidad en el servicio de Ortodoncia / Orthodontic quality management service

RESUMEN Fundamento: Un sistema de gestión de calidad es una valiosa herramienta para perfeccionar los servicios de salud pública. Objetivo: Caracterizar el estado actual de la gestión de la calidad en el servicio de Ortodoncia para contribuir a una atención de calidad en pacientes con anomalías dentomaxilofaciales. Metodología: Se realizó un estudio descriptivo transversal entre septiembre de 2020 y julio de 2021 en la Clínica Estomatológica Docente Provincial de Sancti Spíritus. Se seleccionaron 3 directivos y 12 miembros del equipo básico de ortodoncia. Se midieron las variables: nivel de información y prácticas sobre gestión de la calidad. Se utilizaron métodos del nivel teórico, empírico y de la estadística descriptiva. Resultados: El 50 % de los miembros del equipo básico presentó un nivel bajo de información sobre la gestión de la calidad en el servicio de Ortodoncia. El 100 % de estos y sus directivos, mostraron prácticas medianamente adecuadas en tres de los cinco aspectos evaluados. Conclusiones: El proceso de gestión de la calidad en el servicio Ortodoncia permitió determinar que, aunque existen directivos con experiencia laboral y un equipo básico con preparación científico-técnica, predominaron con el nivel bajo de información, así como las prácticas medianamente adecuadas sobre la gestión de la calidad.

ABSTRACT Background: A quality management system is a valuable tool for improving public health services. Objective: To describe the current state of orthodontic quality management service to contribute to the patients' quality care with dentofacial abnormalities. Methodology: A descriptive cross-sectional study was conducted between September 2020 and July 2021 at the Sancti Spíritus provincial and teaching stomatology center. Three managers and 12 members of the basic orthodontic team were selected. The following variables were measured: level of information and quality management practices. Theoretical, empirical and descriptive statistical methods were used. Results: 50 % of the basic team members had a low level of information on the orthodontic quality management service. 100 % of them also their managers, showed moderately adequate practices in three of the five aspects evaluated. Conclusions: The orthodontic quality management service allowed us to determine that, although there are managers with work experience and a basic team with scientific-technical preparation, a low level of information prevailed, as well as moderately adequate practices on quality management.

El enfrentamiento a la covid-19 en servicios estomatológicos cubanos / Facing COVID-19 in Cuban Dentistry Services

RESUMEN El escenario estomatológico, si no se aplican adecuadamente los protocolos de protección, constituye una importante fuente de infección cruzada entre pacientes y profesionales de la Estomatología. Muchos son los microorganismos involucrados, y a esto se ha incorporado recientemente el SARS-CoV-2. Al tener en cuenta la letalidad mundial de esta enfermedad, es imprescindible reconsiderar si las medidas de bioseguridad establecidas son estrictas y eficaces para evitar su propagación. Fue realizada esta investigación con el objetivo de actualizar información relacionada con la presente pandemia y los modos de actuación que propicien una consulta estomatológica segura en tiempos de COVID-19 (AU).

ABSTRACT The dentistry setting is an important crossed infection source among patients and Dentistry professionals if the protection protocols are not adequately applied. There are many microorganisms involved, and recently SARS-CoV-2 has added to them. When taking into account the worldwide lethality of this disease, it is bare essential reconsidering if the stablished biosafety measures are strict and efficacious to avoid spread. A thematic update was carried out with the aim of updating the information related to current pandemic and the ways of acting propitiating a safe Dentistry consultation in times of COVID-19 (AU).

Situación laboral de los egresados de la Facultad de Odontología de la Universidad de Cartagena / Employment situation of graduates from the University of Cartagena School of Dentistry

RESUMEN Introducción: El seguimiento de los egresados constituye una herramienta para obtener un diagnóstico del contexto donde se desenvuelven e inducir reflexión en las instituciones de educación superior. Objetivo: Identificar la situación laboral de los egresados de la Facultad de Odontologia de la Universidad de Cartagena entre los años 1990 a 1999. Métodos: Se realizó un estudio observacional descriptivo longitudinal retrospectivo. La población estuvo constituida por 517 egresados del programa de odontología en el periodo 1990-1999, y la muestra por 213. Se estudiaron variables como la distribución de los egresados según las características sociodemográficas, la situación laboral, la situación económica, y la relación de la situación laboral con las características sociodemográficas. Resultados: El 82,6 por ciento se encontraba ejerciendo la carrera, de los cuales el 68,5 por ciento se hallaba ubicado laboralmente en la región Caribe y el 73,2 por ciento laboraba en el sector privado. El 70,9 por ciento de los participantes contaba con un ingreso promedio mensual mayor de 2 000 000 de pesos. Con respecto a la dedicación laboral, el 49,8 por ciento invertía tiempo completo en la actividad desarrollada y el tipo de contratación al que pertenecía era término indefinido en el 40,4 por ciento. Conclusiones: A pesar de la gran oferta de odontólogos que existe en Colombia actualmente, la mayoría de los egresados evaluados se encuentran laborando en su carrera, lo que les proporciona ingresos económicos suficientes para poder cubrir sus necesidades(AU)

ABSTRACT Introduction: Following up the employment situation of graduates is a tool useful to obtain a diagnosis of the context where they perform their professional activities and induce higher education institutions to reflect upon the subject. Objective: Identify the employment situation of graduates from the University of Cartagena School of Dentistry in the period 1990-1999. Methods: An observational retrospective longitudinal descriptive study was conducted. The study population was 517 dental professionals graduating in the period 1990-1999, from whom a sample of 213 was obtained. Among the variables analyzed were the distribution of graduates according to their sociodemographic characteristics, employment situation, economic situation and the relationship between employment situation and sociodemographic characteristics. Results: Of the total sample, 82.6 percent were performing tasks related to their university studies. Of these, 68.5 percent had a job in the Caribe region and 73.2 por ciento in the private sector. The average monthly income of 70.9 percent of the participants was above 2 000 000 pesos. As to contractual conditions, 49.8 percent were hired full time and 40.4 percenthad an indefinite term contract. Conclusions: Despite the great offer of dentists in Colombia nowadays, most of the graduates evaluated have a job related to their studies, which provides them with sufficient economic means to meet their needs(AU)

Determinación de la simbología más utilizada en expedientes odontológicos en Costa Rica en el año 2019 con fines de identificación de seres humanos / Determination of the most common symbology used in dental records in Costa Rica in 2019 for identification of human beings

Resumen Introducción: El objetivo de la investigación fue establecer cuál es la simbología utilizada por los profesionales en odontología para documentar los hallazgos odontológicos más comunes en sus expedientes; con la finalidad de incluirla en un formato único odontológico estandarizado con fines de identificación en Costa Rica. Materiales y métodos: Mediante un cuestionario se identificó y comparó la simbología utilizada por profesionales en odontología generales y especialistas para registrar los hallazgos odontológicos en sus expedientes. Se realizó una fase piloto con 8 cuestionarios y posterior a las correcciones se aplicó a una muestra de 49 odontólogos que incluyó a profesionales en odontología generales y de todas las especialidades. Las técnicas estadísticas utilizadas para el análisis de la información recolectada en las encuestas son las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. El procesamiento estadístico de los datos se diseñó una base de datos creada en EPI-INFO 6.4, el procesamiento estadístico de los datos se realizó en SPSS versión 13.0 y en Excel. Resultados: De los 49 participantes, 56% fueron hombres y 44% mujeres. La edad varía entre 25 y 65 años; la edad promedio fue de 44,5 años (IC 95%: 41,7 - 47,3) y una edad mediana [1] de 43 años, la cual no tuvo diferencia estadísticamente significativa (p = 0,552) entre la edad promedio entre los hombres y mujeres. El 70% de los odontólogos usan expediente físico, mientras que sólo un 17% usan expediente digital, y el 13% usan ambos; en el expediente digital es en el que se presenta la mayoría de problemas con un 62,5 %, en comparación al físico que tiene una prevalencia de 36,4% donde el principal problema es que no se comprendió la letra en un 86,7%. Conclusiones: El examen clínico odontológico es de extrema utilidad para colaborar en el proceso de identificación de víctimas mortales, sin embargo, se logró identificar, que no todos los profesionales en odontología en Costa Rica realizan una adecuada documentación en sus expedientes clínicos. Se propone una simbología estandararizada para dicha documentación.

Abstract Introduction: The objective of the research was to establish what is the symbology used by dentistry professionals to document the most common dental findings in their records; with the purpose of including it in a single standardized dental format for identification purposes in Costa Rica. Materials and methods: Through a questionnaire the symbology used by general dentists and specialists was identified and compared to record the dental findings in their files. A pilot phase with 8 questionnaires was carried out and after the corrections, it was applied to a sample of 49 dentists that included general and all specialties dentists. The statistical techniques used for the analysis of the information collected in the surveys are frequency distributions, crossing of variables, comparison of means based on the analysis of variance. The minimum level of confidence for the comparisons was 95%. The statistical processing of the data was designed a database created in EPI-INFO 6.4, the statistical processing of the data was performed in SPSS version 13.0 and in Excel. Results: The sample was conformed by 49 participants, 56% were men and 44% women. The age varies between 25 and 65 years; the average age was 44.5 years (95% CI: 41.7 - 47.3) and a median age [1] of 43 years, which had no statistically significant difference (p = 0.552) between the average age between men and women. A 70% of dentists use physical records, while only 17% use digital records, and 13% use both; digital files present the majority of problems with 62.5%, compared to the written format who has a prevalence of 36.4% where the main problem is that the letter was not understood in an 86.7 %. Conclusions: Dental records are extremely useful to collaborate in the process of human identification in fatalities; however, it was possible to identify that not all dental professionals in Costa Rica make adequate documentation in their clinical records. A standardized symbology is proposed for such documentation.

El expediente clínico electrónico: una opción con posibilidades ilimitadas / The electronic clinical file: an option with unlimited possibilities

El expediente clínico se define como el conjunto de datos médicos y clínicos ordenados y detallados en forma cronológica, que permiten al profesional de la salud plantear un diagnóstico sindrómico y nosológico, con su posterior pronóstico, para finalmente llevar un registro del desarrollo de un tratamiento. Refleja la capacidad resolutiva de la clínica o consultorio, así como la capacidad profesional de su personal, de ahí la importancia de tener un expediente clínico bien integrado, ordenado, completo, legible y en apego a la normatividad vigente (AU)

The clinical file is defined as a set of medical and clinical data, which are ordered and chronologically detailed, allows the health professional to identify a syndromic and nosological diagnosis, with a later prognosis, to finally make a treatment plan. It reflects the resolutive capacity and the professional capacity of the clinician and his staff. Therefore, it becomes a legal document of the greatest importance, having to have the characteristics of being well integrated, orderly, complete, legible and in compliance with current regulations (AU)

Requisitos para la apertura de un consultorio odontológico en México / Requirements for the opening of a dental office in Mexico

La apertura de un consultorio privado es de interés para muchos profesionistas odontólogos. Más allá de las cuestiones económicas o de habilidad técnica, una limitante importante para llevarlo a cabo es el desconocimiento de los trámites administrativos necesarios para ello. Es común que muchos odontólogos se atrevan a mantener en uso un negocio que, la mayoría de las veces, no cumple con este tipo de aspectos, lo que conlleva a ser susceptible a diversas sanciones. El objetivo de este trabajo es enunciar y describir los requisitos básicos para la apertura de un consultorio de prestación de servicios profesionales odontológicos dentro del territorio mexicano. Posterior a una revisión de la legislación y normatividad vigentes en la República Mexicana, se enlistan los trámites realizados ante cuatro dependencias públicas: Servicio de Administración Tributaria (SAT), regulación sanitaria, protección civil y gobierno local. Cabe resaltar que esta información se ofrece bajo ciertas consideraciones, ya que puede existir variación de acuerdo con los lineamientos establecidos por los gobiernos locales de cada entidad federativa. Se concluye que dar cumplimiento con estos requisitos es el primer paso para el adecuado funcionamiento de nuestro negocio, lo cual ayuda a evitar las sanciones correspondientes y el desprestigio del consultorio (AU)

Opening a private dental offi ce is of interest for many dentists. Beyond economic issues or technical ability, an important limitation to carry this out is the unawareness of administrative procedures necessary for it. Commonly, many dentists dare to keep into the business despite not complying with all the necessary procedures, which makes them susceptible to administrative sanctions. The objective of this work is to enunciate and describe the basic requirements for opening a dental service offi ce within Mexican territory. After a review of current legislation and regulation in the Mexican Republic, the procedures performed in four public agencies are listed: The Tax Administration Service (SAT), health regulation, civil protection, and local government. It should be noted that this information is off ered under certain considerations, highlighting that data presented is done in a generic way, since this may vary according to guidelines from local government of each federative entity. It is concluded that compliance with these requirements is the fi rst step for the proper functioning of our business, which helps avoid the corresponding sanctions and disrepute of the private practice (AU)

Nuevo Código de Ética Profesional Odontológica en Chile: Contribución para una Relación Médico-Paciente Moderna / New Code of Professional Ethics for Dentist in Chile: Contribution for a Modern Doctor-Patient Relationship

RESUMEN: El objetivo de este estudio es analizar el Código de Ética propuesto recientemente por el Colegio de Cirujano Dentistas de Chile a la luz de la revisión de los códigos vigentes en otros países del mundo, discutiendo los temas que son más frecuentemente regulados en ellos, en lo referente a la relación médico-paciente. Se llevó a cabo una búsqueda en páginas web de acceso público de los Códigos de Ética Odontológica de Chile, Unión Europea, Estados Unidos, Australia y algunos países latinoamericanos. Se realizó la dentificación, clasificación, selección y análisis de los temas considerados más relevantes. En lo referido a la relación odontólogo-paciente, los temas seleccionados fueron: consentimiento informado, confidencialidad y secreto profesional, discriminación en la atención, atenciones de urgencia, aplicación de estándares de calidad actualizados, y especialización. Existen grandes diferencias en cuanto a la profundidad al tratar cada uno de los temas y en el alcance de las normas dictadas. Creemos que estas diferencias podrían deberse, por un lado, a la diversidad sociocultural de los países de la muestra analizada y, por otro, a las distintas legislaciones existentes sobre estos temas en cada uno de los países de la muestra.

ABSTRACT: The objective of this study was to analyze the new Code of Ethics recently presented by the Chilean Colegio de Cirujano Dentistas, in light of the results obtained in the revision of the Codes of other countries, focusing on the doctor-patient relationship. Search and obtain from public websites, the Codes of Ethics from the European Union, the United States, Australia and some Latin American countries. Identification, classification, selection and analysis of the most relevant topics. Regarding the dentist-patient relationship, the selected topics were: Informed consent, confidentiality and professional secrecy, discrimination in care, emergency care, application of up-to-date quality standards and specialization. We observed important differences in regards to the depth in which each topic is covered, and the scope of the established norms. We believe that these differences may arise as a result, on the one hand, of the sociocultural diversity of the analyzed countries and, on the other hand, of the different legislations that these countries may have in place on those topics.

Establishing an Eco-friendly Dental Practice: A Review.

Have dentists paused to think as to where the gloves, fixer, plastic waste, mercury waste, and X-ray films used in the clinic end up after disposal? Or considered how much water, electricity, and other resources our dental clinics use? Dentists need to take off their tinted glasses and consider the effects of their dental practice on the planet. Though individual dentists generate only small amounts of dental waste, the accumulated waste produced by the profession may have significant environmental impact. Thus the concept of “green dentistry” or “ecofriendly dentistry” has evolved. Eco-friendly dentistry is an environmentally friendly way of practicing dentistry by using techniques and equipment to reduce waste, conserve energy, decrease pollution, and reduce our carbon footprint. The incorporation of eco-friendly dentistry to the dental practice is not only effective from an environmental perspective but is cost-effective for the dentist too. If a dental practitioner is looking for a way to distinguish his clinic from the others, eco-friendly dentistry could be the answer. This article reviews the scientific literature on eco-friendly dentistry and suggests comprehensive steps to start an eco-friendly dental practice.

Minimal intervention dentistry: conceptual integration in the dental curriculum in cariology

The aim of this study was to evaluate the knowledge and practices of minimal intervention den-tistry [MID] in the teaching hospitals of Lahore. The target population for this cross-sectional study consisted of fresh graduates, house surgeons and demonstrators of Restorative Dentistry in the dental schools of Lahore. The questionnaire was prepared to assess the teaching and concepts of minimal intervention dentistry being taught at the undergraduate level. The results showed that 83% of the respondents believed that MID should replace the age old principles of GV Black. The respondents [90-95%] had sound knowledge about the caries risk assessment. However their concepts about clinical management using these techniques of MID were inadequate. In light of this study it is impervious that, a comprehensive practical training guided by the current principles of MID should be designed and implemented to improve present caries management educational program

An 18-year-old patient with Prader-Willi syndrome: a case report on dental management under sedation and general anesthesia

Prader-Willi syndrome (PWS) is a rare genetic disorder reported rarely in dentistry. Dental practitioners should know the features of PWS because affected patients have a variety of dental symptoms. The current report describes a case of PWS. An 18-year-old male patient presented with traumatic injuries. Initial emergency treatments were performed under sedation, and further treatments were conducted under general anesthesia. After adequate healing, periodic follow-up and dietary management according to the patient's age and nutritional phase were recommended. Dental management of PWS patients consists of active preventive measures in addition to dietary consultation according to age and nutritional phase.

Finishing procedures in Orthodontics: dental dimensions and proportions (microesthetics)

OBJECTIVE: The objective of the present article is to describe procedures that can be performed to achieve excellence in orthodontic treatment finishing. The content is limited to microesthetics, which comprises the concept of ideal dental dimensions and proportions (white esthetics) and its correlation with the periodontium (pink esthetics). Standards of normality are described both in their real dimensions (dental height and width), and in those effectively perceived by the observer, the virtual dimensions. METHODS: The best scientific evidence was sought in the literature to support the clinical procedures that must guide the professional to obtain maximum esthetic quality on their treatments. Therefore, it is necessary to investigate what the other specialties in Dentistry expect from Orthodontics and, specially, what they have to offer. Clinical cases will be used to illustrate the dental movement that might maximize treatment outcome and to confront the ideal standards with the current state of the art. CONCLUSION: Treatment quality is directly related to the amount of procedures implemented by the orthodontist, associated with concepts and resources from Periodontics and Dental Prosthesis. Microesthetics cannot be seen in isolation, but rather as the key to establish a pleasant smile (miniesthetics) in addition to a harmonious face (macroesthetics) and a human being with high self-esteem (hyper-esthetics).

OBJETIVO: o objetivo do presente artigo é descrever procedimentos que podem ser realizados para alcançar a excelência na finalização do tratamento ortodôntico. Delimita-se o assunto à micro-estética, que abrange o conceito das dimensões e proporções dentárias ideais (estética branca) e sua correlação com o periodonto (estética vermelha). Padrões de normalidade são descritos tanto em suas dimensões reais (altura e largura dentária), como naquelas efetivamente percebidas pelo observador, as dimensões virtuais. MÉTODOS: buscou-se na literatura a melhor evidência científica para embasar os procedimentos clínicos que devem nortear o profissional para obter a máxima qualidade estética nos tratamentos. E, para tanto, há necessidade de investigar o que as demais especialidades da Odontologia esperam da Ortodontia e, principalmente, o que têm a oferecer. Casos clínicos serão utilizados para ilustrar a movimentação dentária que pode maximizar o resultado final do tratamento, e para confrontar com os padrões ideais para o estado da arte atual. CONCLUSÃO: conclui-se que a qualidade do tratamento está diretamente relacionada à soma de procedimentos implementados pelo ortodontista, associados a conceitos e recursos da Periodontia e Prótese Dentária. A micro-estética não pode ser vista de forma isolada, mas sim como parte fundamental para se estabelecer um sorriso agradável (mini-estética), uma face harmoniosa (macro-estética) e um ser humano com autoestima elevada (hiper-estética).

[Evaluation of awareness of general dentists and dental specialists about dental management of pregnant and diabetic patients]

With advances in medicine, more systemic patients seek dental treatment. On the other hand, oral health care is an essential part of pregnancy and diabetes mellitus health care. The aim of this study was to assess dentist's awareness about dental management of pregnant and diabetic patients. This study was conducted on 106 out of 204 dentists attending in oral medicine congresses and continuous education programs from June 2009 to June 2010. A self-established questionnaire with approved validity and reliability was used. Along with demographic data, some multiple choice questions about dental management of diabetic and pregnant patients were asked. Totally 20 points were assigned to questions and awareness was classified to excellent [18-20 points], good [14-<18 points], moderate [10-<14 points] and poor [<10 points]. Statistical analysis was done by Mann- Whitney and Kruskal-Wallis tests. P-value less than 0.05 were considered significant. The mean awareness score [MAS] was moderate [10.5 +/- 2.5]. The MAS for pregnancy was [3.5 +/- 1.78] of 10 and for diabetes mellitus were [7 +/- 1.32] of 10. MAS were higher in women especially about diabetes mellitus but it was not significantly different. The University of Graduation and years of career were not significantly related to awareness status. Education and treatment attitude for pregnant patients were not related to awareness but women had a higher attitude in treatment of pregnant patients [P<0.05]. The lowest awareness was about indications of consultation in diabetic patients and the highest awareness was about administration of suitable antibiotic and analgesic during pregnancy. The awareness level of dentists studied here was moderate and low about dental management in pregnancy and diabetes mellitus which should be improved via continuous education programs

La gestión por procesos como estrategia de organización para disminuir el riesgo ergonimico en estudiantes de odontología de la Universidad Nacional de Córdoba

Se realizó un estudio exploratorio transversal, durante las actividades prácticas odontológicas de 40 alumnos de cuarto y quinto año de la Facultad de Odontología de la Universidad Nacional de Córdoba (FOUNC). Objetivo general: proponer desde la gestión por procesos una estrategia de intervención para disminuir el riesgo de trastornos musculo esqueléticos por malas posturas; objetivos específicos: diagnosticar el nivel de riesgo de trastornos osteomusculares; describir las principales causas para adopción de posturas incorrectas y proponer un diagrama de actividades como estrategia de mejora basada en gestión por procesos, en un procedimiento.

Summary: A descriptive, exploratory and transversal study was conducted during dental practice activities of 40 students in fourth and fifth year in the Faculty of Dentistry at the National University of Córdoba (FOUN). General Ojective: to propose process management from an intervention strategy to reduce the risk of musculo skeletal disorders by poor posture, specific objectives: to diagnose the level of risk of musculoskeletal disorders, describe the main causes for adopting bab posture and propose diagram activities as a strategy for improvement based on process management in a procedure.